According to research, various factors increase a person’s likelihood of developing endometriosis, such as having:

• A mother, sister, or daughter with endometriosis
• An abnormal uterus diagnosed by a doctor.
• Early menstruation (before age 11)
• Menstrual periods are shorter (less than 27 days on average).
• Heavy menstrual cycles that last more than seven days
• Some factors that can reduce the risk of endometriosis include:
• Pregnancy and breastfeeding.
• Having your first menstruation after the age of 14.
• Consuming fruits, particularly citrus fruits.

Endometriosis Treatment

Endometriosis is commonly treated with medication or surgery. The way you and your health care team choose will be determined by the severity of your symptoms and your desire to conceive.
Usually, medicine is advised first. If it does not provide adequate relief, surgery may be necessary.

Pain medications

Your healthcare provider may recommend over-the-counter pain medications. These medications include ibuprofen (Advil, Motrin IB, and others) and naproxen sodium (Aleve). They can relieve painful menstrual cramps.
If you are not attempting to conceive, your care team may offer hormone therapy in addition to pain medicines.

Hormone Therapy

Hormone therapy can help alleviate or eliminate endometriosis discomfort. The rise and fall of hormones during the menstrual cycle causes endometriosis tissue to thicken, degrade, and bleed. Hormones synthesized in the lab may restrict this tissue’s growth and prevent new tissue formation.
Hormone therapy is not a lasting treatment for endometriosis. The symptoms may return after you discontinue medication.

Treatments for endometriosis include:

• Hormonal contraceptives: Birth control pills, injections, patches, and vaginal rings help regulate the hormones that cause endometriosis. When using hormonal birth control, many women experience lighter and shorter menstrual flows. In some circumstances, hormonal contraceptives can help to alleviate or eliminate pain. The odds of alleviation appear to increase if you use birth control tablets for a year or longer without interruption.
• Gonadotropin-releasing hormone (Gn-RH) receptor agonists and antagonists: These medications disrupt the menstrual cycle and reduce estrogen levels. This causes the endometriosis tissue to shrink. These medications cause an artificial menopause. Taking a low dose of estrogen or progestin in combination with Gn-RH agonists and antagonists may alleviate menopausal symptoms. These include hot flashes, vaginal dryness, and bone loss. Menstrual periods and the potential to become pregnant return when you stop taking the medication.
• Progestin treatment: Progesterone is a synthetic hormone that regulates the menstrual cycle and pregnancy. A variety of progestin therapies can suppress menstrual cycles and endometriosis tissue growth, potentially relieving symptoms. Progestin therapies include a small device put in the uterus that releases levonorgestrel (Mirena, Skyla, and others), a contraceptive rod placed under the skin of the arm (Nexplanon), birth control shots (Depo-Provera), and a progestin-only birth control pill (Camila, Slynd).
• Aromatase inhibitors: These are a class of medications that reduce the level of estrogen in the body. To treat endometriosis, your doctor may prescribe an aromatase inhibitor in addition to a progestin or a combination of birth control pills.

Conservative surgery

Endometriosis tissue can be removed using conservative surgery. It seeks to preserve the uterus and ovaries. If you have endometriosis and are attempting to conceive, this sort of surgery could help. It may also assist if the problem is causing you severe discomfort; however, endometriosis and pain may return following surgery.
Your surgeon may do this treatment with small incisions, often known as laparoscopic surgery. To remove thick bands of scar tissue, surgery with a larger cut in the abdomen is occasionally required. However, most severe cases of endometriosis can be treated laparoscopically.
During laparoscopic surgery, your surgeon inserts a narrow viewing equipment called a laparoscope through a small incision near your navel. Endometriosis tissue is removed using surgical tools inserted through another tiny cut. Some surgeons do laparoscopy using robotic instruments under their control. Following surgery, your doctor may suggest that you take hormone medication to aid with pain management.

Fertility Treatment

Endometriosis can cause difficulty getting pregnant. If you’re having trouble conceiving, your doctor may offer fertility therapy. You may be directed to a reproductive endocrinologist, who specializes in infertility treatment. Fertility treatments may involve medications that stimulate the ovaries to produce more eggs. In vitro fertilization refers to a set of operations that combine eggs and sperm outside of the body. The best treatment for you is determined by your unique circumstances.

Hysterectomy with removal of the ovaries.

A hysterectomy is a surgery that removes the uterus. Endometriosis was originally thought to be treated most effectively by removing the uterus and ovaries. Today, some physicians consider it a last choice for relieving pain when other treatments have failed. Other specialists advocate for surgery that focuses on the meticulous and comprehensive excision of all endometriosis tissue.

Early menopause is caused by oophorectomy, which is the removal of the ovaries. A lack of hormones produced by the ovaries may alleviate endometriosis pain for certain people. Others, however, continue to experience symptoms due to residual endometriosis following surgery. Early menopause also increases the risk of heart and blood vessel disease, certain metabolic problems, and premature death.

Hysterectomy can be used to treat endometriosis symptoms in persons who do not want to become pregnant. These include heavy menstrual bleeding and severe menstruation caused by uterine cramps. Even if the ovaries are not removed, a hysterectomy can have long-term consequences for your health. That is especially true if you undergo the procedure before the age of 35.

To manage and treat endometriosis, select a health care expert with whom you feel at ease. You may wish to get a second opinion before beginning any treatment. This ensures that you are aware of all of your alternatives, as well as the benefits and drawbacks of each one.

Diagnosis and Tests

Endometriosis is often diagnosed based on the symptoms you’re having. If your periods hurt and are heavy, you might want to see a doctor. At your visit, the doctor (a gynecologist) may ask about your medical history and whether anyone else in your family has endometriosis. They are going to do a pelvic check. For the next step, they might ask for imaging tests like an MRI or ultrasound.
Laparoscopy is the only way to be sure that someone has endometriosis. Your doctor will use a laparoscope, a small camera, to look inside your pelvis during this process. They can take a piece of tissue (biopsy) and send it to a lab for tests once they know where the tissue is.

During this operation, the surgeon will also try to remove or destroy any tissue that looks like it might be endometriosis. This is one way that a laparoscopy helps with treatment and evaluation. Because of where endometriotic tumors are located, they aren’t always easy to get rid of without hurting the important structures underneath. A team of doctors, such as minimally invasive gynecologists, colorectal surgeons, or urologists, may need to help with this operation.

Some people find they have endometriosis by accident. Endometriosis doesn’t always cause signs in people who have it. This means that your doctor might find the problem while doing something else.

Unable to have children: Endometriosis

One of the most common diseases in women that makes it hard for them to get pregnant is endometriosis. The American Society for Reproductive Medicine found that between 24% and 50% of women who can’t have children have endometriosis. Endometriosis that is mild to moderate may only make it impossible to get pregnant for a short time. Women can get pregnant with the help of surgery that gets rid of the uterine tissue.

Endometriosis can make it hard to get pregnant, but doctors aren’t sure how. People with endometriosis may have trouble getting eggs from their ovaries or have eggs get stuck in the fallopian tube before they can reach the uterus because of the scar tissue. Endometriosis can also hurt sperm or fertilized eggs before they can connect with an egg in the uterus.

A lot of women who have endometriosis or infertility caused by it can still get pregnant and have a healthy baby. Women may be able to get pregnant with the help of treatments like fertility maintenance and in vitro fertilization (IVF). Talk to your doctor about your plans to get pregnant when you talk about your endometriosis treatment plan.

Prevention

Endometriosis is an idiopathic condition, which means it has no known cause. There are no specific ways to prevent endometriosis. However, being aware of the signs and if you may be at increased risk might help you decide when to consult with a doctor.

Endometriosis can be diagnosed on Sonography and may also need further imaging like MRI to diagnose any deep infiltrating lesions. Endometriosis is an important cause of Infertility. We at Dr Sudha Tandon Fertility, IVF, Gynaec Endoscopy and Maternity center offer both Laparoscopy and Infertility (IVF) treatment for Endometriosis in Mumbai.

Endometriosis is a disease process in which the endometrium which normally lines the uterine cavity is found on other organs especially the ovaries and behind the uterus. Like the endometrium of the uterine cavity, this endometrium also responds to the hormonal changes causing symptoms like painful periods, infertility and pain while having intercourse. There are no blood tests which would definitely clinch the diagnosis of endometriosis. Presence of blood filled cysts in the ovaries on pelvic ultrasonography is again highly suggestive of endometriosis in an infertile woman. The diagnosis of endometriosis can be confirmed on laparoscopy. The treatment of endometriosis depends on the extent of the disease , symptoms and the size of the cyst . The focus of treatment for infertility is on getting the woman pregnant. In the rest of the women with moderate and severe endometriosis the treatment is a combination of laparoscopic surgery followed by medication to suppress the disease. Unfortunately, there is no complete and permanent treatment of endometriosis. Both medicines and surgery cause a temporary relief from the disease process.

Laparoscopy is an excellent tool to diagnose and correct all forms of endometriosis. In mild endometriosis, the endometriotic areas on the undersurface of ovaries and on the uterosacral ligament are cauterized. The endometriotic cysts of the ovaries also known as chocolate cyst are opened and drained, the inner surface of the cyst is cauterized and the cyst wall can be peeled out. The ovaries which are stuck to their base are freed through the laparoscope. In severe endometriosis, uterus could be stuck or adherent posterior to the rectum and this can be released laparoscopically. The fallopian tube which are adherent in a woman with endometriosis can be freed with laparoscopy.

After the surgery, the woman is generally advised Hormone Injections for 3 months whereby her periods stop and the Endometriosis doesn’t progress further. We at Dr Sudha Tandon Fertility, IVF, Gynaec Endoscopy and Maternity center have all the facilities for treatment of Endometriosis in Mumbai under one roof. The couple is encouraged to try for a natural conception. If it does not happen, they should not wait for more than 6 months and quickly decide either on IUI or IVF for getting pregnant.

Endometriosis is a recurrent disease and woman can have recurrence of the endometriotic cyst and may need further surgical treatment. A complete surgical removal can keep the patient symptom free for upto 5 to 6 years. Deep infiltrating nodules may need to be excised . Bowel endometriosis if present also needs to be surgically treated.

We at Dr Sudha Tandon’s fertility , IVF , Gynec Endoscopy and Maternity center have all world class facility for laparoscopic and hysteroscopic surgery and ART for endometriosis treatment in Mumbai.